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> pharmaceutic companies have much more opportunity to sell or advertise their products directly to consumers.

This is true, but I don't think its for the reasons you described. The cause is actually simply that they are legally allowed to advertise. I don't believe there's a single European country that allows pharmaceutical companies to advertise directly to consumers.

Consumers actually have a lot less choice than you'd imagine. You can request prescription medication from a doctor, but they won't necessarily prescribe it. Doctors can prescribe for off label usage, but the pharmaceutical companies are strictly forbidden from advertising that, and often even mentioning it. Doctors only really follow your request if its for an alternative treatment that they agree with. Similar to what you describe, insurance companies can also refuse to pay for drugs with generic alternatives, or request that the doctor follows other forms of treatment first.

Some of the advertising is to drive consumer choice, but it actually may be more for the doctor. Even if they don't prescribe a medication requested by the patient, they're forced to consider the drug, and they'll have the name in their head when reading journals and publications.



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